On Sun, 10 Mar 1996, Naomi Baumslag wrote: By way of introduction I am a
pediatrician who recently joined Lactnet and thoroughly enjoy it. I
recently published "Milk, Money and Madness" (with Dia Michels) and in
the book state that the administration of Vit K in newborns is
controversial. Although most available data on Vit K values for
breastmilk are lower the bioavailability is not clear. Woolridge and
Baum found the concentration of Vit K in colostrum is higher than in
mature milk and that hindmilk has more Vit K than foremilk. Vit K
is also obtained from fetal hepatic stores as well as from milk until the
infant is able to make her own Vit K.  The studies quoted are old and
inadequate and used different measures eg hemorrhagic disease,
intracranial hemorrhagic deaths or circumcision bleeds. The incidence of
intracranial hemorrhagic deaths and hemorrhagic disease is not known.
Some authors recommend IM Vit K to newborn and others say Oral Vit K
is okay.
The problem is also that more sensitive and specific measures of
Vit K deficiency are needed before definitive recommendations can be
made.
The reasons listed for giving vitamin K is to avoid hemorrhage in high risk
babies such as prolonged labor, birth trauma, surgical procedures and
albumenuria. Breastfeeding has also been included as a risk factor but as
Chalmers has pointed out most of the data was derived from earlier studies
where trauma was more common and first feedings delayed.  There is general
agreement that randomized clinical trials are needed to determine when
Vit K is needed.  If you need more info feel free to contact me c/o
[log in to unmask] Naomi Baumslag MD MPH President, Womens
International Public Health Network